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Provider Information for 1629629878

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALEJANDRA GARCIA GOMEZ

Gender: FEMALE

Individual NPI: 1629629878

Calendar   Last Updated:  2019-09-27
  Certification Date: 

Details

Name Value
NPI 1629629878
Enumeration Date 2019-09-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 3303 HARBOR BLVD STE B8
COSTA MESA, CA 92626-1517
United States

Phone: 714-786-6069 | Fax:
View Map External Link
Primary Practice Address 3303 HARBOR BLVD STE B8
COSTA MESA, CA 92626-1517
United States

Phone: 714-786-6069 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 106S00000X - Behavior Technician